Association of Hormone-Replacement Therapy With Various Cardiovascular Risk Factors in Postmenopausal Women

More than 20 studies have been conducted to assess the effects of estrogen replacement on coronary heart disease. The majority of these studies have demonstrated a protective effect of the use of estrogen replacement therapy. Most of these studies have been limited to the postmenopausal use of estrogen alone. Data on the combined use of estrogen and progestin, currently recommended for women who have not undergone a hysterectomy, are more limited. This report assesses the associations of therapy with exogenous estrogen alone, or estrogen combined with progestin, with physical variables related to cardiovascular risk in a large sample of postmenopausal women. This cross-sectional analysis used data from the Athero-sclerosis Risk in Communities study. The study cohort comprised four population-based samples from Forsyth County, NC, Jackson, MS, selected suburbs of Minneapolis, and Washington County, MD. To examine the associations of hormone-replacement therapy, 4958 postmenopausal women participating in this population-based investigation were studied. Women were classified into four groups according to their use of hormone-replacement therapy: current users of estrogen alone, current users of estrogen with progestin, nonusers who had formerly used these hormones, and nonusers who had never used them. Concentrations of plasma lipids, hemostatic factors, fasting serum concentrations of glucose, insulin, and blood pressure were measured.